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ACCU-TELL MORPHINE URINE TEST (CE)

ACCU-TELL MORPHINE URINE TEST (CE)

Declaration: As with all diagnostic tests, a definitive clinical diagnosis should not be based on the result of a single test, but should only be made by the physician after all clinical and laboratory findings have been evaluated.

 

CATALOG

INTENDED USE

                                                                                QUALITY CONTROL
                                                                                PERFORMANCE CHARACTERISTICS
                                                                                REFERENCE

 CATALOG

Catalog No.                    Product Name                                   Note

ABT-DOA-A26                 Morphine Urine Strip                        CE

ABT-DOA-B26                 Morphine Urine Cassette                CE

INTENDED USE
Accu-Tell ® Rapid MOR Urine Test is a lateral flow, rapid immunoassay for the qualitative detection of morphine in human urine at a cut-off of 300 ng/mL. This product is used to obtain a visual, qualitative result and is intended for professional use. The assay should not be used without proper supervision and is not intended for over the counter sale to lay persons.
This assay provides only a preliminary analytical test result. A more specific alternative chemical method must be used in order to obtain a confirmed analytical result. Gas chromatogra-phy/mass spectrometry (GC/MS) has been established as the preferred confirmatory method by the National Institute on Drug Abuse (NIDA). Clinical consideration and professional judgment should be applied to any drug of abuse test result, particularly when preliminary positive results are indicated.
SUMMARY
The opiates such as heroin, morphine, and codeine are derived from the resin of opium poppy. Heroin is quickly metabolized to morphine. Thus, morphine and morphine glucuronide might both be found in the urine of a person who has taken only heroin. The body also changes codeine to morphine. Thus the presence of morphine (or the metabolite, morphine glucuronide) in the urine indicates heroin, morphine and/or codeine use.
Urine based screening tests for drugs of abuse range from simple immunoassay tests to complex analytical procedures. The speed and sensitivity of immunoassays have made them the most widely accepted method for screening urine for drugs of abuse. Rapid MOR Test Cassette is based on the principle of the highly specific immunochemical reactions of antigens and antibodies which are used for the analysis of specific compounds in biological fluids. This test is a rapid, visual, competitive immunoassay that can be used for the qualitative detection of morphine in human urine at 300 ng/ml cut-off concentration.
PRINCIPLE
Accu-Tell ® Rapid MOR Urine Test is a rapid immunoassay in which a chemically labeled drug (drug conjugate) competes with the drug which may be present in urine for limited antibody binding sites. The test device contains a membrane strip which was pre-coated with drug conjugate on the test band. A colored anti-morphine monoclonal antibody-colloidal gold conjugate pad is placed at the right end of the membrane. In the absence of drug in the urine, the solution of the colored antibody-colloidal gold conjugate and urine moves upward, chromatographically by capillary action, across the membrane. This solution then migrates to the immobilized drug conjugate zone on the test band region. The colored antibody-colloidal gold conjugate then attaches to the drug conjugate to form a visible line as the antibody complexes with the drug conjugate. Therefore, the formation of a visible precipitant in the test zone occurs, when the test urine is negative for the drug. When the drug is present in the urine, the drug/metabolite antigen competes with the drug conjugate on the test band region for limited antibody sites on the anti-morphine monoclonal antibody-colloidal gold conjugate. When a sufficient concentration of drug is present, it will fill the limited antibody binding sites. This will prevent attachment of the colored antibody-colloidal gold conjugate to the drug conjugate zone on the test band region. Therefore, absence of the color band on the test region indicates a positive result.
A control band with a different antigen/antibody reaction is also added to the immunochromatographic membrane strip at the control region (c) to indicate that the test has performed properly. This control line should always appear, regardless of the presence of drug and metabolite. This means that negative urine will produce two colored bands, and positive urine will produce only one band. The presence of this colored band in the control region also serves as 1) verification that sufficient volume has been added, and 2) that proper flow was obtained.
STORAGE AND STABILITY
The test kit is to be stored refrigerated or at room temperature 2-30 °C (36-86 °F) in the sealed pouch for the duration of the shelf life.
WARNINGS AND PRECAUTIONS
1.  For in vitro diagnostic use only.
2.  Urine specimens may be potentially infectious. Proper handling and disposal methods should be established.
3.  Avoid cross-contamination of urine samples by using a new specimen collection container and specimen pipette for each urine sample.
SPECIMEN COLLECTION AND HANDLING
Accu-Tell ® Rapid MOR Urine Test is formulated for use with urine specimens. Fresh urine does not require any special handling or pretreatment. Urine samples should be collected such that testing can be performed as soon as possible after the specimen collection, preferably during the same day. The specimen may be refrigerated at 2-8°C for 2 days, or frozen at -20°C for a longer period of time. Specimens that have been refrigerated must be equilibrated to room temperature prior to testing. Specimens previously frozen must be thawed, equilibrated to room temperature, and mixed thoroughly prior to testing.
Note: Urine specimens and all materials coming in contact with them should be handled and disposed of as if capable of transmitting infection. Avoid contact with skin by wearing gloves and proper laboratory attire.
TEST PROCEDURE
Review “Specimen Collection“ instructions. Test device, patient’s samples, and controls should be brought to room temperature (20-30°C) prior to testing. Do not open pouches until ready to perform the assay.
For Test Cassette:
1.  Remove the test cassette from its protective pouch (bring the device to room temperature before opening the pouch to avoid condensation of moisture on the membrane). Label the device with patient or control identification.
2.  Draw the urine sample to the line marked on the pipette. Dispense 3 drops (or 120 μl) into the sample well. Use a separate pipette and device for each sample or control.
3.  Read result between 3 to 8 minutes after the addition of sample. Do not read result after 8 minutes.

For Test Strip:
1.  Bring the pouch to room temperature before opening it. Remove the test strip from the sealed pouch and use it as soon as possible.
2.  With arrows pointing toward the urine specimen, immerse the test strip vertically in the urine specimen for at least 5 seconds. Do not pass the maximum line on the test strip when immersing the strip.
3.  Place the test strip on a non-absorbent flat surface, start the timer and wait for the red line(s) to appear. The result should be read between 3 to 8 minutes after the addition of sample. Do not interpret the result after 8 minutes.

 

INTERPRETATION OF RESULTS
Negative: Two colored lines appear in the viewing window. The line in the test region (T) is the drug probe line; the line on the control region (C ) is the control line, which is used to indicate proper performance of the device. The color intensity of the test line may be weaker or stronger than that of the control line.
Positive: Only one colored line appears in the control region (C ). The absence of a test line indicates a positive result.
Invalid: No line appears in the control region. Under no circumstances should a positive sample be identified until the control line forms in the viewing area. If the control line does not form, the test result is inconclusive and should be repeated.
Note: A very faint line in the test region indicates that the morphine in the sample is near the cut-off level of the test. These samples should be re-tested or confirmed with a more specific method before a positive determination is made.
LIMITATIONS OF PROCEDURE
1.  The assay is designed for use with human urine only.
2.  A positive result with any of the tests indicates the presence of a drug/metabolite only, and does not indicate or measure intoxication.
3.  There is a possibility that technical or procedural errors as well as other substances and factors not listed may interfere with the test and cause false results.
4.  If it is suspected that the samples have been mislabeled or tampered with, a new specimen should be collected and the test should be repeated.
QUALITY CONTROL
Good laboratory practice recommends the use of control materials to ensure proper kit performance. Quality control specimens are available from commercial sources. When testing the positive and negative controls, use the same assay procedure as with a urine specimen.
PERFORMANCE CHARACTERISTICS
Accuracy: The accuracy of Rapid MOR Test was evaluated in compari-son to a commercially available immunoassay at a cut-off of 300 ng/mL. 120 urine samples, collected from presumed non-user volunteers, have been tested by both procedures with 100% agreement.
In a separate study, 74 urine samples, obtained from a clinical laboratory where they were screened and confirmed as positives by the commercially available immunoassay and GC/MS, were tested by Rapid MOR Test . Of the 67 samples with morphine concentration from = 346 ng/mL, all were identified as positives byboth methods (100%) agreement). Of the 7 samples with morphine concentrations from 201-264 ng/mL, all were identified positives by the commercially available immunoassay and all were identified as negatives by Rapid MOR Test .
Reproducibility: The reproducibility of Rapid MOR Test was evaluated at 4 different sites using blind controls. Of the 60 samples with morphine concentration of 150 ng/mL, all were determined negative. Of the 60 samples with morphine concentration of 600 ng/mL, all were determined positive.
Precision: The precision of Rapid MOR Test was determined by conducting the test with spiked controls. The control at 150 ng/mL should give a negative result and the control at the 450 ng/mL should give a positive result.
Concen-tration (ng/mL)
No Tested
Correct Result
% Correct Result
150
50
50
100
450
50
50
100
Specificity: The specificity for Rapid MOR Test was tested by adding various drugs, drug metabolites, and other compounds that are likely to be present in urine. All compounds were prepared in drug-free normal human urine.
The following structually related compounds produced positive results when tested at levels equal to or greater than the concentrations listed below.
Compound
Concentration (ng/mL)
Morphine
300
Codeine
300
Ethyl morphine
300
Hydrocodone
375
Hydromorphone
400
Merperidine
30,000
Morphine-3-glucuronide
490
Norcodeine
30,000
Oxycodone
15,000
Thebaine
30,000
The following compounds were found not to cross-react when tested at concentrations up to 100 μg/mL
Acetaminophen, Acetone, Albumin, Amitriptyline, Ampicillin, Aspartame, Aspirin, Atropine, Benzocaine, Benzoylecgonine, Bilirubin, Caffeine, (+)-Chlorpheniramine, (+/-)-Chlorphenir-amine, Chlorpromarine, Creatine, Desoxyephetrine, Dexbromphenir-amine, Dexbromethorphan, 4-Dimethyl-amino-antipyrine, Dopamine, Doxylamine (+/-)-Ephedrine, (-)-Ephedrine, (+)-Epi-nephrine, Erytromycin, Ethanol, Furo-semide, Glucose, Guaiacol Glyceryl ether, Hemoglobin, Hydromorphone, Hydro-codone, Hydroxytyramine, Imipramine, (+/-)-Isoproterenol, Lidocaine, Naloxane, Naltrexone Naphthalene acetic acid, (+)-Naproxen, (+/-)-Norephedrine, 11-nor–Δ9-THC-9-carboxylic acid, Oxalic Acid, Oxycodone, Peni-cillin-G, Pentamine, Pentobarbital, Pheniramine, Phenobarbital, Phenothiazine, L-Phenyl-ephrine, D-Pro-poxyphene, Quinidine, Riboflavin, Secobarbital, Sodium Chloride, Sulindac, Thioridazine, Trifluorperazine, Tyramine, Vitamin C
REFERENCE
1.  Baselt, R.C. Disposition of Toxic Drugs and Chemicals in Man, Biomedical Publications, 1982
2.  Urine Testing for Drugs of Abuse. National Institute on Drug Abuse (NIDA), Research Monograph 73, 1986
3.  Fed. Register, Department of Health and Human Services, Mandatory Guidelines for Federal Workplace Drug Testing Programs, 53, 69, 11970, 1988
4.  McBay, A.J. Clin. Chem. 33, 33B-40B, 1987

5.  Gilman, A.G., & Goodman, L.S. The Pharmacological Basis of Therapeutics, eds. MacMillan Publishing, New York, NY, 1980.

 

The above information is just for reference. The actual technical specifications are subject to the insert provided with the product.